Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2672 | CT |
N | 152W00000X | Optometrist | CT2672 | CT |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2672 | CT |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 2672 | CT |
N | 152WP0200X | Pediatric Optomitrist | 2672 | CT |
N | 152WS0006X | Sports Vision | 2672 | CT |
N | 152WV0400X | Optomitrist - Vision Therapist | 2672 | CT |
NPI | 1154492718 |
---|---|
Provider Name | Dr. Maha Ramamurthy |
First Address | Wethersfield, CT 06109-3043 |
Second Address | Wethersfield, CT 06109-3043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 17/03/2018 |